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Tricuspid pouch forms during the spontaneous closure of a ventricular septal defect (VSD). Cases have been reported in which the tricuspid pouch was discovered for the first time during surgery and could not be distinguished from an aneurysm of the membranous septum( AMS). A 58-year-old woman had a heart murmur. Transthoracic echocardiography showed an aneurysm-like pouch protruding into the right ventricle. Magnetic resonance imaging could not distinguish between AMS and tricuspid pouch;however, contrast-enhanced computed tomography showed a VSD. The membranous structure comprised multiple lobules, and the tendon of the papillary muscles was continuous with the tricuspid valve. Intraoperatively, the tricuspid valve septal leaflet was adhered to the defect hole. It was incised along the annulus, the VSD was closed with a bovine pericardial patch, and the annulus of the tricuspid valve septal leaflet was suture closed. The patient was discharged after a good postoperative course.

Aim: One of the pitfalls in managing multiple liver tumors is the difficulty in identifying individual tumors on ultrasonography. Computed tomography (CT)-assisted virtual sonography has been shown to improve sonographic diagnosis, however it requires additional equipment and software. We have developed a simple reconstruction method of virtual sonography (SRVS)., Methods: We reconstructed SRVS mimicking ultrasonographic images, utilizing a workstation software attached to a multi-detector row CT system without any additional program., Results: We have performed SRVS in 32 patients with 41 liver tumors that could hardly be identify on ultrasonography. SRVS assisted the identification of malignant form non-pathologic ones and thereby contributed to the appropriate clinical strategy including RFA (18 tumors), liver biopsy (2 tumors), other therapies (4 tumors) and follow-up (17 tumors)., Conclusion: We have developed virtual sonography using conventional CT software. SRVS seems useful in the clinical practice in managing liver tumors.